Publications

OHIP Fraud

The Ministry of Health and Long-Term Care is committed to detecting abuse and misuse of the Ontario health care system

What is OHIP fraud?

It includes :

Someone knowingly using a health card that is not theirs

Someone receiving OHIP services who is aware that as a non-resident of Ontario they are not eligible.

Someone who knowingly gives false information to the ministry to become or continue to be an insured person when they are aware that they are not eligible.

To report suspected cases of abuse, the public may call the ministry at: 1 888 781-5556
Reports can be made anonymously or by sending an e-mail to the ministry at : reportohipfraud@moh.gov.on.ca

Who is eligible for Ontario health insurance coverage?

Generally speaking, Canadian citizens, permanent residents or landed immigrants, convention refugees (protected persons), or a person registered as an Indian under the Indian Act, or others listed in Regulation 552 under the Health Insurance Act are eligible for Ontario health insurance coverage provided they :

Make their primary place of residence in Ontario, and

Are physically present in Ontario for at least 153 days in any 12-month period.

In order to ensure that only eligible Ontario health card holders have access to publicly funded health services, OHIP eligibility assessments are conducted by the ministry on a routine basis.

The ministry investigates each and every allegation it receives regarding potential health insurance abuse.